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Healthcare by a Pharmacist mum!


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WonderBaba Guide – Suppositories versus Oral Medicine?

Well this is an interesting one as there are a few different factors which need to be considered.  For the purposes of this article I am speaking about the use of suppositories to treat fever and pain, and not referring to their use in constipation.  For more information on constipation and how it can be treated effectively click here.

Untitled design (17)The first thing I have to say is that suppositories are not as scary as some people think, they are just cone-shaped boluses of medicine which can be easily given to your child to treat pain of fever when a liquid is not suitable.  Suppositories available to treat fever and pain include ones based on paracetamol such as Paralink and Tipol, and ones based on ibuprofen such as nurofen.  These are both suitable from three months of age – just make sure to read the packaging to get the correct dosing for your child.

Before I go into the detail of how you actually use suppositories I’m going to get straight to the point and tell you when you SHOULD  use suppositories.

  • Use them if your child has a high fever or is in pain and will not or cannot take oral medication.
  • Use them to treat fever or pain when your child has vomiting.
  • My mummy perspective suggests using them when you are travelling to avoid having to carry lots of liquids.. I suggest this only for young children who are quite happy to use a suppository over oral meds.

What are the pros and cons?

question markUsing suppositories is more invasive than using oral medicine so a correct approach and a respect for your child’s comfort is essential.  I will explain in the next section how to use them but now I just want to emphasise that when used properly with a willing child they are so simple, easy and convenient to use.  I personally feel that a child who is still in nappies is an ideal candidate for this method of giving medicine – they are used to you cleaning and touching their nappy area and so will not be distressed when you insert the suppository – in fact many children will not even notice!! I also think it is a different situation when a child is out of nappies and unless you have the child’s permission and general understanding of what is going to happen I think the oral route of medicine is best when possible.  Another factor to consider is that suppositories have been proven effective for the treatment of pain or fever but they may actually take a little longer to take effect than oral medicine.

When faced with a vomiting child with a high temperature that needs to come down, or a child with a jaw so tightly clenched and unwilling to take oral medicine it is definitely a good idea to have suppositories on stand by.

So how to you use them?

For this bit I’m going to cheat and provide you with a perfect explanation from the Great Ormond Street Children’s Hospital in London:

“Remember – suppositories should never be swallowed.

  • Sit your child on the toilet to see if they need a poo.
  • Wash your hands.
  • Warm the suppository in your hands for a minute.
  • Remove the foil or plastic wrapping.
  • Get your child into any of these positions to give the suppository:
    • squatting down
    • lying on one side with one leg straight and the other bent
    • standing up with one leg raised
  • Gently but firmly push the suppository into your child’s bottom as instructed.
  • Push it in far enough that it does not slip out again.
  • Ask your child to close their legs and hold your child’s buttocks together for a few minutes.
  • Wash your hands again.

If your child needs a second suppository, wait until the first has dissolved before inserting the second.”

I will add that for younger children such as babies in nappies I would advise that you place them on their backs and proceed to change their nappy – when you have the dirty nappy off and area wiped clean I would hold their legs back gently towards them with their knees bent and insert the suppository then and continue with the nappy change as normal.

cropped-websitefeetlogo.pngSome Useful Hints

  • If the suppository is warm before you open it you can run the wrapper under a cold tap or place it in a fridge for a few minutes to cool it as it can not be inserted when melted.
  • Being calm and confident will help your child to feel calm and confident in your actions.
  • If your child will take oral medicine and finds the use of suppositories distressing then do not persist – just offer oral medicine when necessary.
  • If you would like some tips on how to give your child oral medication then just click here!
  • Having a book ready so that you can scoop your child into your arms and settle them on your knee to read a story which will help them sit still to allow the suppository to absorb.
  • You should always consider the psychological welfare of your child and explain everything that you are doing – I even do it with babies even though they may have no idea what I’m talking about so that they get used to you respecting their personal space from an early age.
  • Sometimes the advice I have to give can make the process sound scarier than it really is – I assure you – babies in nappies most often are quite happy for you to administer a suppository and it can be such a great means to reduce a temperature that you may otherwise struggle to.

 

doctor-logo-red-white-mdWho should not use suppositories?

  • Children who have had bowel surgery unless prescribed by a doctor
  • Children who have an oncological condition or are otherwise immunocompromised.
  • Children who have irritable bowel disease.

 

websitefeetlogoI hope you found this information helpful and as always don’t hesitate to contact me on the WonderBaba Facebook page (https://www.facebook.com/wonderbabacare) with any questions or for one to one advice for your little one! You can also consult with me in person at Milltown totalhealth Pharmacy in Dublin 6 or over the phone on 012600262.

 

References:

 

 


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A WonderBaba Guide to Childhood Vaccinations in Ireland!

 

It has been announced that the HSE intend to roll out a new Primary Childhood Immunisation Programme this year which will mean that all babies who are born on or after the 1st of October 2016 will receive two new vaccines as part of the programme.  The two new vaccines include MenB (at 2,4 and 12 months) and Rotavirus (at 2 and 4 months). The timing  if the 1st MenC vaccine will also change from 4 to 6 months and the timing of the third PCV will change from 12 to 13 months.  Currently Hib and MenC are given as two separate vaccines but will now change to one injection which combines the two vaccinations at 13 months. The changes are best understood by looking at the following chart:

the new pci schedule

Reference : http://www.immunisation.ie

The vaccines which are shown in yellow text are new and the ones in green text in the chart have had changes to the timings as described above.  Children who have started on the ‘old schedule’ i.e those born before the 1st October 2016 will complete the ‘old schedule’.  As a parent of three I understand that vaccination schedules will change with time and that the most relevant vaccines at the time of my children’s birth have been offered to them.  There has to be a starting point for any new vaccination schedule and I suppose this is why there is no ‘catch up’ programme planned that I am aware of. Any parent of a child born before the 1st October 2016 who wishes to get their child vaccinated against MenB or the Rotavirus will have to discuss it with their GP who may prescribe it for them privately but the parent would need to pay for the vaccinations as they will not be covered under the child’s state funded immunisation schedule.

The changes to the Primary Immunisation Programme are very likely to go ahead but the HSE have yet to engage in negotiations with the Irish Medicines Organisation (who represent the GP’s who are responsible for administering the vaccines) to form an agreed framework for the implementation of the programme. Once that has been completed then the new vaccination programme should go ahead as planned.

The Primary Childhood Immunisation programme exists to help protect our babies and children from preventable diseases.  The more we vaccinate the more we move towards eradicating these diseases from Irish health. Whilst I strongly advise vaccination it is also only fair to point out that it is optional and you should always offer your consent before a vaccination takes place.  This article aims to allow you to make that decision in a more informed manner.  I hope for you to understand what vaccines your child is receiving and for what illnesses. I also hope you will find my ‘Parents Tips’ at the end useful for making the vaccination process less scary and intimidating for your child as a relaxed and prepared parent allows a child to be confident and relaxed in your care. Continue reading


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Meningitis – Do you know what you’re looking for?

Meningitis describes an infection of the meninges.  The meninges are the protective membranes surrounding the brain and spinal cord.  The infection can be viral or bacterial.

mother and babyViral infections, whilst very scary, are usually not life threatening.  Hospital tests are often required to differentiate between bacterial and viral menigitis and it’s extremely important to seek medical attention if meningitis is suspected as urgent antibiotic treatment is needed for the bacterial form of the disease.  Examples of viruses which can cause meningitis are enteroviruses and the herpes simplex virus. Continue reading


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Can I give Calpol and Nurofen together?

Without any shadow of doubt the most common question I am asked is whether Calpol and Nurofen can be taken together.  To explain the answer fully it is important to first look at the active ingredients in these preparations, also what other products contain these active ingredients, and then how we can use them safely. Continue reading


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Sore Throats in Babies and Children

Sore Throats in Babies and Children Wonder

Unfortunately sore throats are quite common, especially in children, and can occur for several reasons including viral or bacterial infections. One of the main viral infections which causes a sore throat is the common cold with it being responsible for a quarter of all sore throats. Other viruses which less commonly cause a sore throat in children are the flu viruses, the herpes simplex virus, the Epstein Barr virus (glandular fever), and the Adenovirus. Bacterial infections only account for a third of sore throats in children and are mostly due to streptococcal infections. Babies and children are particularly likely to suffer from sore throats as their bodies haven’t yet had time to build up resistance to the infections which commonly cause this nasty symptom. Continue reading


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Ear Infections in Children – A Guide for Parents!

Ear infections in children

An ear infection is inflammation of the middle section of the ear which can be caused by a viral or bacterial infection. An ear infection causes fluid to build up behind the ear drum which is what causes the pain. It often occurs after a sore throat, cold or upper respiratory infection as these ailments give way to a perfect breeding ground for bacteria and also make it easy for viral infections to spread to the middle ear. Sore throats, colds, and upper respiratory infections cause inflammation of the passageways between the ear and the throat and as children have smaller eustachian tubes than adults, and less efficient immune systems, it makes them even more susceptible. In fact, 75% of children will experience an ear infection by the time they celebrate their third birthday! Continue reading


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Temperatures – what they are and how to treat them!

 

Temperatures – What they are and how to treat them!

babyunderarmA fever/temperature in children usually indicates that they have picked up a bacterial or viral infection but can also be a result of a reaction to a vaccine or becoming overheated.
A child’s normal temperature can range from about 97°F/36.1°C up to 99.4°F/37.4°C. Most doctors consider a temperature of 100.4°F/38°C or higher as a fever when measured using an oral, ear or rectal thermometer.

Continue reading